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Rural Anaesthesia Journal Club: December 2018

Hello,

The 3rd instalment of the Rural Anaesthesia Down Under / Broome Docs podcast is now out.

I invited a few of my Broome gas colleagues tot he microphone to share their thoughts on a few recent articles relevant to GP anaesthesia.

Dr Mel Little returns to the microphone.  This time we are joined by Dr Sascha Saharov and Dr Trent Little (no relation).  The papers we discuss are below with a few summary thoughts.  Have a listen to the podcast if you want to hear more and please comment if you have insights or questions for us.

Click on the PLAYER below or download us from your preferred podcast app / player (we actually fit inside your phone!)


Does IV Lignocaine actually work for perioperative pain?

Dr Mel Little takes a look at the recent Cochrane Review by Weibel et al.

It seems that the more data included by the Cochrane team, the less sexy lignocaine seems… and we still do not have a decent set of safety data despite its widespread application in modern anaesthesia.

 


  The next kid on the list has a runny nose…. should we delay his anaesthesia?

Dr Trent LIttle presents the data from this French study:

Peri-operative respiratory adverse events in children with upper respiratory tract infections allowed to proceed with anaesthesia   F. Michel et al  European Journal Anaesthesiology 2018 

The risk of a perioperative respiratory adverse event is high.. about 1/3,, but the risk of a serious adverse outcome is low.  Good to know the numbers to inform decision-making with colleagues and patients / parents.


Midazolam for premedication.  Does it fix anxiety, pain or anything?

Dr Sascha Saharov dives into this Korean paper that tries to measure the effects of midazolam.  As a bonus there is a Dutch trial of various benzos for sedation in patients undergoing PCI…  turns out midazolam probably doesn’t fix anxiety!

A randomized controlled trial assessing the effectiveness of midazolam premedication as an anxiolytic, analgesic, sedative, and hemodynamic stabilizer  by Jeon et al in Medicine, Aug 2018


Humans are bad at stuff, we screw things up.  Anaesthetists are human.  How can we make anaesthesia safer?

Our FOAMed friends Drs Stu Marshall and Nicholas Chrimes have written a lovely editorial on medication safety in Anaesthesia.  The paper contains a handy infographic that you could put up on the wall adjacent to the trolley.

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